You’re getting your child ready for school one morning when you notice something odd: they’re standing with their knees touching, but their feet are apart. “Is this normal?” you wonder. “Could something be wrong with their legs?”
First, take a deep breath. What you’re noticing might be knock knees, a common condition that many children go through as they grow. The good news? Most cases are harmless and resolve on their own. But some might need a little help, and knowing when to act can make all the difference.
Let’s walk you through everything parents in Singapore need to know about knock knees — what causes them, what to look out for, and how a podiatrist or physiotherapist can help correct the condition.
What are knock knees?
Knock knees, or genu valgum, is when a child’s knees angle inwards and touch each other when standing straight, while the ankles remain apart.
It can make their gait look a little awkward, like their legs are curving inward when they walk or run. But here’s the reassuring part: knock knees are a normal developmental stage for many children.
Is it normal for children to have knock knees?
Yes — in fact, it’s extremely common.
- Around 20% of children between the ages of 3 and 6 display some degree of knock knees.
- It typically appears after age 2 and peaks around age 4, then gradually improves.
- By age 7 or 8, most children’s legs straighten out naturally.
So in many cases, knock knees are just a part of growing up. But if it lingers beyond the age of 8, becomes more pronounced, or is causing pain, it’s time to dig deeper.
What are the main causes of knock knees?
While most cases are part of natural development, some underlying factors can contribute, especially if the knock knees are more severe or persistent:
- Flat feet or poor foot posture cause misalignment from the ground up
- Nutritional deficiencies, such as Vitamin D deficiency (rickets)
- Excess weight can increase stress on growing bones and joints
- Bone conditions, like Blount’s disease (rare but worth ruling out)
- Injury or infection that affects bone growth
- Genetics, some kids may inherit a tendency toward inward angling knees
Do knock knees get worse with age?
In most children, knock knees improve on their own with time. But in some cases, especially if left unmanaged, it may:
- Worsen during growth spurts
- Causes knee, hip, or foot pain due to poor alignment
- Affect balance or sports performance
- Lead to uneven wear on the knee joint in adulthood
This is why early screening and monitoring are important, especially if the condition is causing pain, is one-sided, or appears beyond the usual age range.
Can you correct knock knees?
Yes — and the earlier you act, the better the results.
While mild cases may resolve naturally, moderate to severe knock knees can be corrected through conservative treatments like physiotherapy and custom insoles. The goal is not just to “make the legs look straight,” but to improve how your child moves, stands, and feels.
How to fix knock knees: Our treatment approach
At Physio & Sole Clinic, we combine podiatric expertise (foot and lower limb alignment) with physiotherapy (strength and movement retraining) for a holistic solution.
Here’s how we typically help children with knock knees:
1. Clinical Assessment
We begin with a detailed evaluation of:
- Foot posture and arch support
- Leg alignment and gait (walking pattern)
- Joint flexibility and muscle strength
- Family history and footwear habits
This helps us understand what’s contributing to your child’s knock knees.
2. Custom Insoles or Orthotics
If your child has flat feet, customised insoles can help support their arches, rebalance leg alignment, and reduce pressure on the knees.
✅ A 2021 study published in Gait & Posture found that orthotics significantly improved lower limb alignment in children with flat-foot-related knock knees.
3. Physiotherapy Exercises
Our physiotherapists design child-friendly exercises to:
- Strengthen hip and thigh muscles (especially the glutes)
- Improve core and postural control
- Stretch tight muscles, like the IT band
- Reinforce good walking patterns
These exercises are often gamified to keep kids engaged — think “crab walks” or “monster steps!”
4. Movement & Postural Education
We teach your child how to sit, stand, and move in ways that reduce unnecessary stress on the knees, both in the clinic and at home.
5. Monitoring Progress
We track improvements over time and adjust treatment as your child grows. Most kids respond well within a few months of consistent care.
When should you see a podiatrist or physiotherapist?
See a professional if your child’s knock knees:
- Persist past age 7–8
- Seems to be getting worse
- Causes pain in the knees, hips, or feet
- Affect their walking or running
- Look uneven (only one leg affected)
- Interfere with daily activities or confidence
Will my child need surgery?
Very rarely. Surgery is typically only considered for:
- Severe knock knees that don’t respond to therapy
- Underlying bone disorders
- Older teens with significant functional limitations
The good news? Over 90% of cases can be treated conservatively, especially when addressed early.
Real Story: Emma, Age 6
When Emma’s mum noticed her daughter’s knees turning inwards, she brought her in “just to be safe.” Emma loved running, but had started to trip more often.
Our team found she had mild knock knees and flat feet. With custom orthotics and weekly physiotherapy, Emma’s alignment improved within 6 months — and her mum noticed a boost in her confidence, too.
Final Takeaway: Don’t panic — just be proactive
If you’re worried about your child’s knock knees, don’t feel like you need to figure it out alone. We’re here to assess, explain, and support — in a way that’s practical, personalised, and parent-friendly.
With the right care, most kids bounce back stronger and straighter than ever.
Concerned about your child’s leg alignment?
Let our podiatrists and physiotherapists take a closer look. Early support can make all the difference. Call us or book an appointment here!
